实用老年医学

实用老年医学 ›› 2024, Vol. 38 ›› Issue (2): 128-131.doi: 10.3969/j.issn.1003-9198.2024.02.005

• 临床研究 • 上一篇    下一篇

老年腹腔镜胆囊切除术后感染发生率及危险因素分析

陈文军, 芮一奇, 王鹏, 高骥, 白剑峰, 石毅   

  1. 210024 江苏省南京市,南京医科大学附属老年医院普外科(陈文军,芮一奇,王鹏);210029 江苏省南京市,南京医科大学第一附属医院肝胆中心(高骥,白剑峰,石毅)
  • 收稿日期:2023-04-05 出版日期:2024-02-20 发布日期:2024-02-26
  • 通讯作者: 石毅,Email:2037511652@qq.com
  • 基金资助:
    国家自然科学基金资助项目(82101873)

Analysis of incidence and risk factors of infection in elderly patients after laparoscopic cholecystectomy

CHEN Wenjun, RUI Yiqi, WANG Peng, GAO Ji, BAI Jianfeng, SHI Yi   

  1. Department of General Surgery, Geriatric Hospital of Nanjing Medical University, Nanjing 210024, China(CHEN Wenjun, RUI Yiqi, WANG Peng); Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China(GAO Ji, BAI Jianfeng, SHI Yi)
  • Received:2023-04-05 Online:2024-02-20 Published:2024-02-26
  • Contact: SHI Yi, Email:2037511652@qq.com

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摘要： 目的 统计病人老年腹腔镜胆囊切除术(laparoscopic cholecystectomy, LC)后感染发生情况,并分析其影响因素。 方法 选取2021—2022年于南京医科大学附属老年医院行LC的140例老年病人为研究对象,统计病人住院期间感染发生情况,并记录基线资料及实验室指标,包括WBC、PLT、白蛋白(ALB)、降钙素原(PCT)和CRP,分析老年LC病人术后发生感染的影响因素。 结果 140例老年LC病人住院期间发生感染28例(20%);与未发生感染组比较,发生感染组病人年龄、手术时机＞72 h比例和伴胆囊结石比例均明显升高,ALB水平明显降低,差异有统计学意义(P＜0.05或P＜0.01)。多因素Logistic回归分析结果显示,手术时机＞72 h、伴胆囊结石、血清ALB水平降低可能是老年LC病人术后发生感染的独立危险因素(OR=21.012、9.082、0.888,P＜0.05)。 结论 手术时机＞72 h、伴胆囊结石及血清ALB水平降低是老年LC病人术后感染的独立危险因素。   

关键词: 腹腔镜手术, 老年人, 术后感染, 危险因素

Abstract: Objective To investigate the incidence of postoperative infection in the elderly patients receiving laparoscopic cholecystectomy(LC), and to investigate the influencing factors. Methods A total of 140 elderly patients who underwent LC in Geriatric Hospital of Nanjing Medical University from January 2021 to December 2022 were enrolled in this study. The incidence of infection during hospitalization was recorded, and the baseline data and laboratory indicators including white blood cell count(WBC), platelet count(PLT), albumin(ALB), procalcitonin(PCT) and C-reactive protein(CRP) were collected. The influencing factors of postoperative infection in the elderly patients after LC were analyzed by Logistic regression analysis. Results Among the 140 elderly patients receiving LC, 28 cases(20%) presented with infections during hospitalization. Compared with the non-infection group, the infection group showed higher proportion of surgeries conducted more than 72 hours after admission, higher incidence rate of gallbladder stones and lower ALB level(P<0.05 or P<0.01). Logistic regression analysis showed that surgeries conducted more than 72 hours after admission, the presence of gallbladder stones, and low serum ALB level was independent risk factors for postoperative infections in the elderly patients after LC(OR=21.012, 9.082, 0.888, P<0.05). Conclusions Surgeries conducted more than 72 hours after admission, gallbladder stones and low serum ALB level can affect the incidence of postoperative infection in the elderly patients after LC.

Key words: laparoscopic surgery, aged, postoperative infection, risk factors

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